22
Diagnosis
Table 8. Racial/Ethnic Issues in Evaluation, Risk Decisions,
and Treatment of ASCVD Risk
Racial/Ethnic Groupings
Asian
Americans
a
Hispanic/Latino
Americans
b
Blacks Comments
Treatment
Lifestyle
counseling
(use principles
of
Mediterranean
and DASH
diets)
Use lifestyle
counseling to
recommend
a heart-
healthy diet
consistent with
racial/ethnic
preferences to
avoid weight
gain and
address BP and
lipids.
Use lifestyle
counseling to
recommend a
heart-healthy
diet consistent
with racial/ethnic
preferences to
avoid weight gain
and address BP
and lipids.
Use lifestyle
counseling to
recommend
a heart-
healthy diet
consistent
with racial/
ethnic
preferences to
avoid weight
gain and
address BP
and lipids.
Asian and
Hispanic/
Latino groups
need to be
disaggregated
because of
regional
differences
in lifestyle
preferences.
Challenge
is to avoid
increased
sodium, sugar,
and calories
as groups
acculturate.
Intensity of
statin therapy
and response
to LDL-C
lowering
Japanese
patients may
be sensitive to
statin dosing. In
an open-label,
randomized
primary-
prevention
trial, Japanese
participants
had a reduction
in CVD events
with low-
intensity doses
of pravastatin
as compared
with placebo.
In a secondary-
prevention
trial, Japanese
participants
with CAD
benefitted from
a moderate-
intensity dose
of pitavastatin.
No sensitivity to
statin dosage is
seen, as compared
with non-Hispanic
white or black
individuals.
No sensitivity
to statin
dosage is seen,
as compared
with non-
Hispanic
white
individuals.
Using a lower
statin intensity
in Japanese
patients may
give results
similar to
those seen
with higher
intensities in
non-Japanese
patients.
